LITTLE FALLS, N.J. -- Patients who exercised frequently before having a stroke may recover more quickly than those who were sedentary, researchers say.

Action Points

Explain that patients who had moderate to high levels of physical activity before having a stroke had better outcomes in terms of functionality than those who didn't exercise.

LITTLE FALLS, N.J., July 21 -- Patients who exercised frequently before having a stroke may recover more quickly than those who were sedentary, researchers say.

Odds of a good outcome were higher for those who reported moderate to high levels of physical activity before their stroke compared with those who reported low levels, James F. Meschia, MD, of the Mayo Clinic, and colleagues reported in the July issue of the Journal of Neurology, Neurosurgery & Psychiatry.

"It makes sense," Dr. Meschia said. "A brain that generally has good blood and oxygen flow from aerobic exercise will be in a better position to compensate for neurological deficits caused by a stroke."

It's established in the literature that exercise holds many benefits in terms of cerebrovascular disease, including improved endothelial function and reduced blood viscosity, fibrinogen levels, and platelet aggregability.

However, the effect -- if any -- of pre-stroke physical activity on functional status after stroke is not well studied.

So the researchers looked at data from the Ischemic Stroke Genetics Study of 673 patients who'd had a first-ever ischemic stroke from December 2002 to November 2007.

Patients were asked about levels of activity prior to their stroke.

The researchers looked at three measures of functional outcome and one measure of neurological impairment at enrollment and after three months.

A total of 50.5% reported exercising less than once a week, while 28.5% reported exercising one to three times weekly, and 21% reported four or more times per week.

The researchers found that patients who reported less exercise in the year before their stroke were significantly more likely to have one or more bad outcomes (P<0.001).

On the other hand, the odds of a good outcome were higher for those who reported moderate to high levels of activity before their stroke, the researchers said.

They added that there was little difference in outcomes between those with moderate and high levels of activity (P<0.05).

After three months, both moderate and high exercise levels were associated with significantly better functional outcomes. But in adjusted analyses, only the association with one measure of functionality remained significant.

The researchers said they think the trends are accurate, but greater study power is needed.

Some of the potential mechanisms by which exercise improves outcomes: active patients may have greater cardiovascular reserve and may demonstrate better hemodynamics after a stroke, as well as better collateralization of flow after arterial occlusions and better oxygen extraction from the blood.

Or, they may have higher neuromuscular reserves and may be better able to compensate for deficits as a result, the researchers said.

With a study limited by self-reported physical activity data and a retrospective design, the researchers noted that they don't know what amount of activity "would be required to show a positive effect."

They also noted an inability to generalize from these results as all patients were evaluated at dedicated stroke centers, and all included cases representing first-ever ischemic stroke.

The researchers also pointed out the possibility of selection bias. "Because this study used data obtained from patients enrolled in an ischemic stroke genetics study that required written informed consent, the study population tends to skew mild in severity of deficit," they wrote.

"This problem is compounded by the fact that 1 of the 5 ISGS centers did not allow enrollment of subjects by surrogate consent. This led to consent bias toward subjects with milder strokes."

They added that their findings "should be seen as exploratory, requiring confirmation, ideally in a longitudinal study of exercise in an older population."

The Ischemic Stroke Genetics Study was supported by a grant from the National Institute of Neurological Disorders and Stroke.

Accessibility Statement

At MedPage Today, we are committed to ensuring that individuals with disabilities can access all of the content offered by MedPage Today through our website and other properties. If you are having trouble accessing www.medpagetoday.com, MedPageToday's mobile apps, please email legal@ziffdavis.com for assistance. Please put "ADA Inquiry" in the subject line of your email.